Provider Demographics
NPI:1114431848
Name:BRAVERMAN, FRANK A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:BRAVERMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 ROAD D
Mailing Address - Street 2:
Mailing Address - City:REDWOOD VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95470-9794
Mailing Address - Country:US
Mailing Address - Phone:707-367-1458
Mailing Address - Fax:
Practice Address - Street 1:3 MARCELA DR
Practice Address - Street 2:
Practice Address - City:WILLITS
Practice Address - State:CA
Practice Address - Zip Code:95490-5769
Practice Address - Country:US
Practice Address - Phone:707-456-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist